Inpatient Care Management Medical Director

Optum is seeking an Inpatient Care Management Medical Director to join their team. This role involves conducting acute level of care and length of stay reviews for medical necessity for members. The Medical Director will collaborate with nurses and support staff to manage inpatient care utilization at various levels, working remotely from anywhere within Florida.

Practice Info

• This team is responsible for conducting acute level of care and length of stay reviews for medical necessity for members being managed within the continuum of care.
• Clients include local and national commercial employer, Medicare, and state Medicaid plans.
• The Medical Directors work with groups of nurses and support staff to manage inpatient care utilization at a hospital, market, regional or national level.
• The role is remote, allowing work from anywhere within the state of Florida.
• The Optum ICM Medical Director's work is typically concentrated in a region, but they are part of a national organization and team.

Responsibilities

• Participate in telephonic outreach for collaboration with treating providers, including discussion of evidence-based guidelines, opportunities to close clinical quality/service gaps, and care plan changes.
• Collaborate with operational and business partners on clinical and quality initiatives at the site and customer level.
• Apply evidence-based medicine (EBM) such as InterQual care guidelines and criteria review.
• Occasionally, participate in periodic market oversight meetings with Chief Medical Officers, network contractors, nurse management, and other internal managers.
• Participate in rotational holiday and call coverage.
• Maintain proficiency in all required software and platforms.

Compensation

• The salary for this role will range from $248,500 - $373,000 annually based on full-time employment.
• Incentive and recognition programs.

Benefits

• A comprehensive benefits package.
• Equity stock purchase.
• 401k contribution.

Requirements

• MD or DO with an active, unrestricted medical license in the state of Florida (Required)
• Currently reside in the state of Florida (Required)
• Current Board Certification in an ABMS or AOA specialty (Required)
• 3+ years of clinical practice experience post residency (Required)
• Technical proficiency in computer software and systems (Required)
• Private home office and access to high-speed Internet (Required)
• Ability to participate in rotational holidays and call coverage (Required)
• 2+ years of managed care, Quality Management experience and/or administrative leadership experience (Preferred)
• UM experience (Preferred)
• Clinical experience within the past 2 years (Preferred)